MEDICARE: EPISCOPAL RESIDENTIAL HEALTH CARE FACILITY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	1401332N	NY
2	251E00000X	Home Health Agency	1401907L	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	00030238701	OTHER	NY	UNIVERA ID FOR LT
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	0000033	OTHER	NY	ADAP PROVIDER REGISTRATN

General Provider Information

NPI Number	:	1629295720
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EPISCOPAL RESIDENTIAL HEALTH CARE FACILITY, INC.

Provider Business Mailing Address
First Line	:	24 RHODE ISLAND ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14213-2142
Country	:	US
Telephone Number	:	716-614-0666
Fax Number	:	716-614-0840

Provider Business Practice Location Address
First Line	:	24 RHODE ISLAND ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14213-2142
Country	:	US
Telephone Number	:	716-614-0666
Fax Number	:	716-614-0840

Authorized Official
Title or Position	:	CFO AND VICE PRESIDENT
Name	:	MR. JAMES JULIANO
Credential	:
Telephone Number	:	716-614-0666

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	09/11/2025

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